Are you a longtime customer of ABA therapy? Maybe you’re just getting started, and looking for a framework you can use to assess ongoing effectiveness. Either way, it is a good idea to familiarize yourself with some key tenets of effective ABA. There are some metrics that you can keep in the back of your mind and make an ongoing assessment based on your experience. There are also certain key indicators of success that you don’t necessarily need to measure yourself directly. These are outcomes that should be measured on an ongoing basis by your ABA providers. Your providers will share progress with you based on these data. They’ll compare notes with you to make sure the data reflects your lived experience, and figure out how to fix the measurement strategies if it doesn’t. In this article, we’ll discuss ways to measure the effectiveness of ABA, and what you should look for in a provider. These metrics and strategies apply whether you’re currently searching for a new provider, or looking for ways to evaluate your current program and make adjustments – or decide that it’s time for a switch.
Client Outcomes
Firstly, the effectiveness of ABA is measured by client outcomes. This includes progress within overarching goals to increase skills and quality of life across the social, behavioral, and communication domains. It also includes progress on smaller component skills, like following directions or asking for help, that contributes to overall progress. Client outcomes are measured by incremental data collection that happens during every therapy session. The data can be collected by hand on a datasheet, or via a data collection computer program or app. But the data means nothing unless it is aggregated and analyzed. That’s why the data will also be charted or graphed, again either by hand or on a computer program (like Excel) or a software program specifically designed for ABA programs. Then, the BCBA regularly reviews the data in conjunction with their observations and uses it to make adjustments to the program.
Client outcomes are also measured via summary level progress reporting, using the data collected over time to show the picture of progress over time. This information is also used to make decisions about ongoing goals, recommended treatment hours, and plans for the transference of skills to natural environments.
Family Outcomes
The effectiveness of ABA is also measured by family outcomes. This is prevalent not only for families of young children with autism but also families of adults with autism. This is because the resources available to support people with autism change over time, and there may be more responsibility on the family as the person transitions into adulthood. It becomes critical for the family to have an adequate support network. They may also have the goal to transition their family member to a living situation outside of their own home at some point. Family outcomes for younger children will likely overlap considerably with the child’s goals. For example, the family may be seeking a successful and safe school placement in a neighborhood school, or the ability to hold playdates at the family’s home or at a peer’s home without issue. Family outcomes for adults with autism may start to diverge, including the ability to transition more goal direction, life planning, and preference selection to the individual. Families might set goals for their own transition period to “empty nesting” and shift more responsibility for independent functioning to their child or family member with autism who is now no longer living with them. However, both sets of outcomes are equally important in measuring the impact of ABA.
Community Member Outcomes
A little known area of impact of ABA is upon other members of the community. This includes direct relationships – neighbors, advocates, friends, and cousins to name a few – as well as indirect relationships. Indirect relationships include community members like grocery store clerks, baristas, fitness center regulars, and church members. Community member outcomes can be measured via simple surveys or interviews. Community member outcomes can help to assess individual understanding and ability to modify expectations and provide ad-hoc supports in the moment. They also help to assess overall readiness of the community environment to support the person with autism and allow for making adjustments as needed. (Read more about Community Outcomes)
Social Validity
“Social validity” simply means to evaluate how the Person with ASD and their family feel about ABA therapy. This critical area goes hand in hand with program outcomes data in evaluating the effectiveness of ABA. (Learn more about social validity here) For example, if a child makes progress on acquiring a new skill like tooth brushing according to the data as it is analyzed by the BCBA, but the family reports that the method of teaching the new skill was extremely stressful for them, then the intervention was not effective. Assessing social validity early and often in the program helps ensure that the ABA methods used adhere to best-fit strategies for particular clients and families. It also encourages families to take an active role in their child’s therapy program by communicating what does and does not work for them.
Generalization
In order to be effective, ABA must establish outcomes across environments, people, and situations. This means that all skills taught need to be applicable in real-world contexts. It also means that ABA programming needs to include practice opportunities for newly acquired skills in those real-world contexts until they become fluent. Common generalization environments include home, school, sports, and other enrichment or extracurricular activities. A skill specifically taught in one environment may need to be retaught in others until it is easily called upon in the moment. Common people in a child with Autism Spectrum Disorder’s environment include parents, teachers, siblings, peers, coaches, and tutors. It may be necessary to provide coaching to all of these people at some point or another to increase practice opportunities for new skills across people. Situations include common routines, games, and activities like zoo trips or theater movies. The more situations that new skills are practiced in, the more likely they are to become durable components of an individual with Autism Spectrum Disorder repertoire for successfully navigating the world around them.
Sources and Additional Resources
Our program prioritizes assessing effective impact early and often. Learn more about our therapeutic philosophy here.
Learn more about Social Validity here.
